Individual provider Active NPI

Tina M. Peer, N.P.

  • Family Nurse Practitioner
  • Twin Falls, ID
National Provider Identifier
1346635463
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-1540A Issued in ID
Practice address
625 Pole Line Rd W Ste 2a
Twin Falls, ID 83301-4270
Phone
(208) 814-8740
Fax
(208) 814-8955
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP1540A ID
Family Nurse Practitioner 363LF0000X NP-1540A ID Primary

Addresses

Primary practice location

625 Pole Line Rd W Ste 2a
Twin Falls, ID 83301-4270

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

704 2nd Ave N Ste 302
Twin Falls, ID 83301-5746
Phone (208) 207-9422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151104000433 ID Practitioner - Nurse Practitioner 6002126042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

625 Pole Line Rd W
Twin Falls, ID 83301-4270

746 N College Rd
Twin Falls, ID 83301-3486

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Hospital & facility affiliations

  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP1540AIDMDNurse Practitioner
NP-1540AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Magic Valley Regional Medical Center LTD Past Accepting new patients
LB Medical Consultants Past Accepting new patients
LB Medical Consultants PastSince Jul 21, 2024 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1346635463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 POLE LINE RD W STE 2A",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014270",
            "telephone_number": "208-814-8740",
            "fax_number": "208-814-8955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 2nd Ave N Ste 302",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833015746",
            "country_code": "US",
            "telephone_number": "208-207-9422",
            "fax_number": "208-269-5828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEER",
        "first_name": "TINA",
        "middle_name": "M.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP1540A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1540A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.